title: A stabilization device to improve the quality of cardiopulmonary resuscitation during ambulance transportation: a randomized crossover trial.
abstract: BACKGROUND
  The quality of cardiopulmonary resuscitation (CPR) during ambulance transportation is suboptimal, and therefore measures that can improve the quality are desirable.
  
  
  OBJECTIVE
  To evaluate whether the use of a stabilization device can improve the quality of CPR during ambulance transportation.
  
  
  METHODS
  This randomized controlled crossover trial enrolled 22 experienced ambulance officers. Each participant performed CPR in an ambulance under three conditions with 72 h apart, each condition for 10 min: non-moving (NM), moving without device (MND), and moving with device (MD). The sequences of conditions were randomized. The primary outcomes were effective chest compressions recorded by the Laerdal Resusci-Anne Skill-reporter manikin. The secondary outcomes included the severity of back pain scored using the Brief Pain Inventory short-form, the physiology parameter before and after CPR, and the changes in postural stability which was represented by the sway index (SI) of lower back measured using a goniometer.
  
  
  RESULTS
  The overall effective compressions in 10 min were 87.0±17% for NM, 59.0±19% for MND, and 69.0±23% for MD (p<0.001). Compared to MND, MD had a lower no-flow fraction while driving on curved sections (0.04 vs. 0.29, p<0.001). Whereas the pain severity and social interference scores were similar under all conditions, MND had a higher SI than MD and NM.
  
  
  CONCLUSIONS
  The use of a stabilization device can improve the quality of CPR and posture stability during ambulance transportation, although the effects on the severity of back pain were not significant.
authors.affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan; Department of Emergency Medicine, Tainan Municipal An-Nan Hospital, China Medical University, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Ning-Ping
authors.initials: NP
authors.lastname: Foo
authors.forename: Jer-Hao
authors.initials: JH
authors.lastname: Chang
authors.forename: Shih-Bin
authors.initials: SB
authors.lastname: Su
authors.forename: Hung-Jung
authors.initials: HJ
authors.lastname: Lin
authors.forename: Kow-Tong
authors.initials: KT
authors.lastname: Chen
authors.forename: Ching-Fa
authors.initials: CF
authors.lastname: Cheng
authors.forename: Tsung-Yi
authors.initials: TY
authors.lastname: Lin
authors.forename: Pei-Chung
authors.initials: PC
authors.lastname: Chen
authors.forename: How-Ran
authors.initials: HR
authors.lastname: Guo
mesh_terms: D000328:Adult; D000552:Ambulances; D001416:Back Pain / Q000517:prevention & control; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D018592:Cross-Over Studies; D006801:Humans; D008297:Male; D008348:Manikins; D009784:Occupational Diseases / Q000517:prevention & control; D010147:Pain Measurement; D011187:Posture / Q000502:physiology; D011785:Quality Assurance, Health Care; D014187:Transportation of Patients
keywords: Ambulance; Back pain; Cardiopulmonary resuscitation; Goniometer; Sway index; Transportation